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Components of Promising Peer Led Sexual Health Programs Print

The prevalence of sexual risk behaviors among teenagers and young adults demands continued attention. Eighty five percent of the teenage pregnancies that occur each year are unintended.1 Each year, about three million teens contract a sexually transmitted disease (STD).2 While condom use rates are rising, only 54 percent of sexually active, in-school teens report consistent use.3 Finding effective ways to educate and motivate young people to avoid sexual risk behaviors is an ongoing challenge. Peer education*, with its grounding in social learning theory, draws upon the resources and existing social networks of young people to engage them in disease and pregnancy prevention among their peers. Peer education is experiencing a boom in popularity as programs are established in schools and universities, clinics, youth serving organizations, community based groups, and religious institutions.

Overwhelming amounts of anecdotal evidence vouch for the positive effects of peer education. Even more significantly, preliminary research indicates the promise and exciting possibilities of peer education. Despite the compelling stories and promising research, however, more scientific evaluation is needed. Specifically, more impact evaluation data must be collected and analyzed before peer education can be unequivocally touted as an effective prevention method.

While the goals of peer education programs may be similar, the philosophies and methods guiding such programs are often very different. Currently, centralized monitoring does not exist for the hundreds of peer education initiatives being implemented. Assistance in designing programs can be expensive and hard to find. As with any approach, certain programs will be more successful than others. This monograph presents a synthesis of elements of the most promising prevention strategies identified and used by peer led sexual health programs.4,5,6,7,8 By using the existing body of knowledge, program funders, planners, coordinators, and administrators can make the best use of scarce prevention dollars and maximize the positive benefits of programs for peer educators, their audiences, and the sponsoring organizations.

Designing the Program

  • Begin with a clearly defined target population. Consider age, gender, race/ethnicity, sexual orientation, socioeconomic factors, neighborhoods, whether the youth are in or out-of-school, etc. If data is available from local health departments, consider which groups of youth appear to have the highest rates of STDs or unintended pregnancy when targeting the intervention. Research other existing programs, and look for underserved members of the community.
  • Include members of the defined population from the beginning of the planning process. This means youth. Their participation will ensure that the program is a product of the community, helping create a feeling of ownership in the program and its goals rather than that it has been foisted upon the community by 'outsiders.' Youth must be invited not merely as tokens but as full participants. Young people should be present from the beginning, and their opinions and suggestions considered seriously. Meetings should be after school, accessible by public transportation or with transportation provided. Snacks and, perhaps, childcare can also help to keep young representatives participating.
  • Set a clearly defined program with realistic goals and objectives. One program cannot address all the issues facing teens, and a group of ten teenagers will not be able to reduce rates of STDs or pregnancy in a state, county, or town in six months. However, ten teenagers could present 12 workshops to 200 students over a period of 9 months and host a health fair that reaches 350 students or, over the period of 6 months, implement a curriculum in 10 health classes at the local high school, reaching 70 students. A time period and the number of people to be reached for each objective will help define the program and target population as well as ensure measurable goals and objectives.
  • Plan realistically for evaluation in the time line and budget. Whether a detailed process evaluation or a long-term impact evaluation, it must be planned from the beginning, or data gathered will be partial and inconclusive. The quantifiable objectives developed for the program will define the data to be gathered. Changes in knowledge will be measured by pre- and post-testing peer educators and participants. Process evaluation data may include numbers and characteristics of program activity participants, post-workshop satisfaction measures, focus groups data from workshop participants, and peer educator journal entries recording activities and referrals. Evaluation is a worthy investment. Demonstrating success encourages funders to support the program. Process evaluation allows ongoing assessment program strengths and weaknesses.
  • Find the right person or people to coordinate the program. Much of the success of a peer education program will rest on the program coordinator(s) who must understand youth and enjoy working with them. The coordinator must also be comfortable with the goals and objectives of the program. The coordinator should display a non-judgmental perspective while establishing high standards of expectation for program participants.

Implementing the Program

  • Recruit peer educators from a broad base of potential candidates. Consider opinion leaders within the defined population, but look also for those who strongly believe in the program's goals and objectives and want to help achieve them. Some of the most effective peer educators do not initially appear to be ideal candidates. Successful recruiters will search out young people, rather than simply expecting them to respond to a flyer or notice. Enlist teachers and other community and agency staff to make recommendations and to publicize the program among their youth.
  • Decide what incentives the program will provide for the peer educators. Some programs offer school credit or volunteer service hours. Local merchants may be willing to donate shirts, snacks, or discount coupons. Other programs build peer educator wages into their budgets. Programs that do not pay the peer educators may attract a limited or non-representative group of candidates.
  • Provide sufficient training for the peer educators. Skills development is as crucial as knowledge. Training empowers peer educators to recognize when to refer a peer to a professional. The training should model the supportive and interactive techniques that peer educators themselves will use. Successful programs will have ongoing training for the peer educators, times to practice existing skills and to develop new ones.
  • Select a curriculum to maximize interactive and experiential learning. Peer education works best when young people work with one another to learn new things or to develop new skills. Youth lectures are no more effective than adult lectures. Peer educators should be trained in facilitating and processing as well as in giving clear directions. Peer educators gain ownership of the program when they play a role in deciding which activities to use or in designing new ways to present the information.
  • Remember that research shows peer education to be most effective when part of a comprehensive initiative. Link peer educators with school nurses, 'youth friendly' local clinics, community agencies, and programs with similar goals. Ensure that peer educators know when and where to refer another young person. A local health professional from a teen clinic or other 'youth friendly' health provider may serve as an advisor to the peer educators and program staff and as a link to health services.
  • Monitor the peer educators' work. After the initial training, peer educators will need ongoing supervision of their work and training. Peer educators should keep a log of informal activities. Monitoring will highlight skills or knowledge that need strengthening. Feedback will also help the young people become more skillful and effective educators.
  • Provide ongoing encouragement and support. Peer educators work hard and their work is not always easy. Positive feedback and support will help keep trained youth involved, as will encouraging them to support each other and providing occasional incentives, such as pizza parties or small trips.
  • Expect attrition and have a formal structure for recruiting and training new peer educators. Youth have many competing interests; some may decide they do not enjoy being peer educators. Exit interviews will help gauge whether they are leaving for personal or programmatic reasons. Involving current peer educators in the recruitment and training of new peer educators will also empower them and help them develop new skills.
  • Provide opportunities for peer educators to give feedback about the program, its activities, and their own performance. The peer educators usually know what they need to become more effective and to enjoy their work more.
  • Finally, promote the program. Develop literature showcasing services and highlighting accomplishments. Positive stories from the peer educators and feedback from workshop participants will enliven databased reports. These materials will increase visibility and encourage potential funders to invest in to peer education program.

Written by Jane Norman, February 1998

Sources for Information, Technical Assistance, and Curricula

Guide to Implementing TAP: Teens for AIDS Prevention

A step-by-step guide to developing and implementing an HIV prevention peer education program in schools and communities. The guide is available online. For ordering information, contact 2000 M Street NW, Suite 750, Washington, DC 20036; or call 202.419.3420.

Peer Education… a Little Help from Your Friends: A How-To Manual

Developed by Planned Parenthood Centers of Western Michigan, this 40-hour comprehensive health training provides a multitude of original as well as adapted ideas, activities, and materials. For ordering information, contact Planned Parenthood Centers of West Michigan, 425 Cherry SE, Grand Rapids, MI 49503; or call 616/774-7005.

Healthy Oakland Teens

A school-based, peer-led AIDS prevention program for junior high school students. Evaluation showed that students who received AIDS prevention counseling from their peers were significantly less likely to engage in potentially risky vaginal intercourse than students who were not involved in the peer-led counseling. The curriculum is available via the Center for AIDS Prevention Studies Web site, along with a Knowledge, Attitudes, Behavior, Belief questionnaire for use with teens and pre-teens. URL: http://www.caps.ucsf.edu/capsweb/hotindex.html. Contact Center for AIDS Prevention Studies, 74 New Montgomery, Suite 600, San Francisco, CA 94105; or call 415/597-9100.

Peer Facilitator Quarterly

The official publication of the National Peer Helpers Association. For subscription information, contact the National Peer Helpers Association, PO Box 10627, Gladstone, MO 64188-0627; or call 877/314-7337.

PeerHelp: A New LISTSERV for Peer Helper Programs and Training

Created to help those interested in peer helping share information such as ideas, techniques, and resources this requires access to electronic mail. For more information or to subscribe, contact Dr. Russell Sabella, School of Education, University of Louisville, Louisville, KY 40292: or call 502/852-0625; E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

References

* A note about terminology: although many people use the terms peer helping, peer tutoring, peer counseling, and peer education interchangeably, they represent different concepts and different goals. For the purposes of this document, peer education refers to sexual health workshops given by and for adolescents.

  1. Trussell J. Koenig J. Stewart F. et al. Medical care cost savings from adolescent contraceptive use. Fam Plann Perspect 1997:29:248.
  2. Alan Guttmacher Institute. Sex and America's Teenagers. New York, NY: The Institute, 1994.
  3. Kann L, Warren CW, Harris WA, et al. Youth Risk Behavior Surveillance, United States. 1995. MMWR CDC Surveillance Summaries 1996:45(SS-4): 1 -84.
  4. Holtgrave D, Qualls N. Curran J. et al. An overview of the effectiveness and efficiency of HIV prevention programs. Public Health Reports 1995:110:134-146.
  5. Janz N. Zimmerman M, Wren P. Evaluation of 37 AIDS prevention projects: successful approaches and barriers to program effectiveness. Health Educ Q 1996:23:80-97.
  6. Kirby D. No Easy Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy, 1997.
  7. HIV Education and Prevention Working Group. What are the Characteristics of HIV Education and Prevention Programs that 'Work' and 'Do Not Work'? HIV Education Prevention Working Group Meeting August 7, 1991. San Francisco, CA: Office of AIDS, California Dept. of Health Services, 1991.
  8. Davis L. Components of Promising Teen Pregnancy Prevention Programs. [Issues at a Glance] Washington, DC: Advocates for Youth, 1996.
This publication is part of Issues at a Glance series.
 
La prevención del VIH/ETS y los hombres jóvenes que tienen relaciones sexuales con hombres Print

También disponible en inglés [HTML].

La prevención del VIH y otras enfermedades de transmisión sexual (ETS) que está dirigida a hombres homosexuales raramente responde a las necesidades de los hombres jóvenes que tienen relaciones sexuales con hombres (siglas en inglés YMSM*). Algunos YMSM no prestan atención a los mensajes dirigidos a homosexuales porque no se identifican como tales. Muchos YMSM temen el estigma social y la violencia—intensificados algunas veces por la cultura y la religión—dirigidos a quienes se identifican como tales. Otros se identifican como bisexuales y no internalizan los mensajes dirigidos a los homosexuales. Algunos adolescentes varones, inseguros de su orientación sexual, ven las relaciones sexuales con personas del mismo sexo como experimentales y pasajeras. Debido a que rara vez se identifican como homosexuales, estos YMSM pueden no reconocer los comportamientos inseguros que los ponen en riesgo de infección por el VIH/ETS.1,2

Por otra parte, los programas de prevención del VIH/ETS dirigidos a adolescentes suelen excluir a los YMSM. La mayoría de los esfuerzos de prevención llevados a cabo en las escuelas intentan convencer a todos los adolescentes de que son susceptibles al VIH/ETS. De esta manera, estos programas inadvertidamente excluyen los mensajes dirigidos específicamente a los YMSM. Los currículos escolares que contienen mensajes como "el SIDA no es una enfermedad de homosexuales" pueden llevar a que algunos YMSM que se identifican como tales piensen que no están en riesgo. Algunos programas escolares deliberadamente ignoran la existencia de jóvenes que se identifican como homosexuales y de YMSM que no se identifican como homosexuales. Estas deficiencias en los mensajes de prevención subestiman la necesidad de programas que se enfoquen en YMSM, al margen de la autoidentificación, y que contengan mensajes que reconozcan y reflejen la diversidad entre los YMSM.

Muchos YMSM manifestan comportamientos que los ponen en riesgo de infección con VIH/ETS

Según varios estudios, entre el 27% y el 48% de YMSM habían practicado sexo anal sin protección durante los previos seis meses.3,4,5 En un estudio, el 63% de los YMSM habían corrido "riesgos extremos" de previa exposición al VIH por sexo anal sin protección y/o el uso de drogas inyectables.6 Al igual que otros adolescentes, muchos YMSM pasan por una etapa de experimentación sexual caracterizada por múltiples compañeros sexuales. El riesgo de contraer el VIH/ETS aumenta con el número de compañeros sexuales. En un estudio, el 44% de los YMSM dijieron que habían tenido por lo menos 10 compañeros sexuales.5 Algunos YMSM exploran sus sentimientos o tratan de esconder o cambiar su orientación sexual a través de tener sexo con mujeres jóvenes. Un estudio indicó que los YMSM que tienen sexo con mujeres son hasta dos veces más propensos a tener sexo sin protección con sus compañeros sexuales masculinos que los que sólo tienen sexo con hombres.7

La comunicación asertiva con los compañeros acerca del sexo más seguro es muchas veces difícil para los YMSM que no tienen modelos a imitar o una educación sexual adecuada, pero que están explorando relaciones íntimas con hombres.6 Como los adolescentes están 10 a 17 veces más predispuestos a usar condones si se sienten cómodos hablando del SIDA con sus compañeros, los YMSM que no tienen apoyo y destrezas están en riesgo de tener sexo inseguro.8 Un estudio indicó que los YMSM discutieron el uso de condones con menos de un tercio de sus últimos tres compañeros y su status respecto al VIH con aún menos compañeros.6 El no conocer bien al compañero también puede entorpecer la comunicación acerca del sexo más seguro. En efecto, un estudio indicó que, después del asalto sexual, los encuentros sexuales en lugares anónimos constituyen el factor que mejor predice el sexo sin protección entre los YMSM.7 Por otro lado, algunos YMSM creen que las relaciones estables los protegerán del VIH y usan condones con menos frecuencia en estas relaciones.3,6,9

Por falta de apoyo social en una sociedad homofóbica, muchos YMSM empiezan usar alcohol y drogas. Comparados con los jóvenes heterosexuales, los jóvenes homosexuales, lesbianas, bisexuales y transgénero están dos veces más predispuestos a usar alcohol, tres veces más predispuestos a usar marihuana y a mostrar síntomas serios del abuso de drogas, y ocho veces más predispuestos a usar cocaína.9,10 El uso de alcohol o drogas hace que la negociación del sexo más seguro sea más difícil y aumenta la probabilidad de tener sexo sin protección.11,12

Es más factible que los comportamientos sexuales de riesgo resulten en la transmisión del VIH en poblaciones donde ya existe un alto porcentaje de infección.13 Un estudio de YMSM en seis condados urbanos indicó que entre el 5% y el 9% de los YMSM estaban infectados con el VIH.4 A nivel nacional, la categoría principal de exposición al VIH para adolescentes varones de 13 a 19 años es la del sexo con personas del mismo sexo, constituyendo el 46% de los casos cumulativos de VIH y el 34% de los casos cumulativos de SIDA. Entre jóvenes de 20 a 24 años la proporción de casos aumenta al 55 y al 63%, respectivamente.14 En una encuesta entre YMSM que tomaron la prueba para detectar el VIH, 70% de los que resultaron VIH-positivos no sabían que estaban infectados.3

La homofobia social pone a los YMSM en mayor riesgo

Hasta un 80% de los jóvenes homosexuales, lesbianas, bisexuales y transgénero reportan sentirse aislados socialmente y emocionalmente.15 Cambios físicos y psicológicos ponen a muchos adolescentes en riesgo de infección por VIH/ETS, pero los jóvenes con dudas acerca de su orientación sexual enfrentan un riesgo más alto porque ellos "de manera particular…crecen sintiéndose diferentes y solos."16 Usualmente a los jóvenes homosexuales, lesbianas, bisexuales, y transgénero les falta apoyo de sus pares y muchas veces enfrentan abuso verbal y físico debido a su orientación sexual. Una cuarta parte de YMSM se ve forzada a abandonar su hogar a causa de su orientación sexual; hasta la mitad de estos jóvenes recurren a la prostitución para mantenerse—aumentando significativamente su riesgo de tener sexo sin protección.17 Los YMSM suelen no tener modelos positivos debido a que muchos adultos homosexuales tienen miedo de revelar su orientación sexual.

Como otros adolescentes, los YMSM necesitan relaciones íntimas; pero muchas veces tienen que obtenerlas sin apoyo o aprobación social. Al esconder sus identidades y deseos, muchos YMSM tienen una necesidad de afecto que sobrepasa cualquier otra preocupación, incluyendo su salud. La hostilidad social hacia las relaciones íntimas entre personas del mismo sexo puede hacer que para los YMSM éstas sean "la única forma de…escapar el aislamiento social y emocional."1

Los YMSM pueden internalizar la homofobia, y algunos llegan a creer los mitos de que los hombres homosexuales no pueden mantener relaciones y que están destinados a morir del SIDA.18 Muchas veces la homofobia internalizada resulta en una autoestima baja y depresión. De hecho, los YMSM son siete veces más predispuestos a intentar suicidio que los jóvenes heterosexuales.19 Mientras los jóvenes heterosexuales visualizan su futuro hasta los 50 años, muchos adolescentes homosexuales no se imaginan sus vidas más allá de los 33 años.19 Muchos YMSM creen que no hay nada bueno en llegar a ser un adulto homosexual. Un YMSM respondió, "muchos jóvenes homosexuales [creen] que el VIH…significa que no voy a estar aquí en 10 a 15 años, y yo no quiero estar aquí [en ese momento]."19

Muchos hombres homosexuales de mayor edad conocieron el SIDA a través de la muerte de amigos, y su sensación de pérdida personal creó un cambio sin precedentes en los comportamientos de riesgo dentro de la comunidad gay adulta.13 Aunque los YMSM que consistentemente practican sexo anal más seguro se perciben como susceptibles al VIH,20 pocos han presenciado las consecuencias fatales del sexo inseguro, y muchos no se sienten particularmente susceptibles al VIH. Aunque el apoyo de los pares con respecto al sexo más seguro es una de las mejores maneras de fomentar el uso de condones, muchas veces los YMSM no tienen este apoyo.3,21 Algunos YMSM pueden asociar el VIH con homosexuales mayores y asumir que sus compañeros jóvenes, aparentemente saludables, son VIH-negativos. Al faltarles modelos que sean VIH-negativos, algunos YMSM consideran la infección con VIH como un ritual de paso hacia la vida de la comunidad homosexual adulta.16 El considerarse invulnerables es una característica de los jóvenes pero es especialmente un problema para los YMSM, teniendo en cuenta su riesgo de contraer el VIH y sus tasas más bajas de sexo más seguro, comparadas con las de los homosexuales de mayor edad.22

El racismo pone a los YMSM de color en más alto riesgo

Los YMSM de color enfrentan dos tipos de discriminación—racismo y homofobia—que pueden aumentar su riesgo de contraer el VIH. En efecto, los YMSM de color tienen tasas más altas de VIH/SIDA que los YMSM blancos. En un estudio, el 7.8% de latinos, el 12.5% de asiáticos y el 14.3% de afroamericanos estaban infectados con el VIH—mucho más que el 3.9% de los YMSM blancos.5 Algunos YMSM de color pueden estar más predispuestos a no tener una noción adecuada de su riesgo de contraer el VIH que los YMSM blancos.13,24 En un estudio, el 64.3% de YMSM indo-americanos dijeron que habían practicado sexo anal sin protección, siendo esto más de lo que fue reportado por cualquier otro grupo étnico-racial.5

Estas diferencias suelen deberse a la falta de intervenciones cultural y lingüísticamente apropiadas para las comunidades de color. Debido a las barreras creadas por la homofobia y el racismo, las intervenciones para los YMSM de color tendrían que enfocarse tanto en estrategias comunitarias que reflejen los matices culturales como en cambios de comportamiento individual.23,24 Por ejemplo, un estudio sugiere que las intervenciónes deben concentrarse en aumentar la capacidad colectiva de los YMSM afroamericanos para enfrentar el VIH y desarrollar la tolerancia hacia los YMSM dentro de las comunidades afroamericanas.24

Los programas efectivos deben desarrollar destrezas y afirmar el valor de los YMSM

La falta de información, información errónea y la homofobia son comunes en la educación sexual que se imparte en las escuelas.25 Algunos educadores deciden o son obligados a enseñar que el comportamiento homosexual es inaceptable. Muchos asumen que todos los estudiantes son heterosexuales y enseñan la reducción de riesgo solamente en términos de contacto heterosexual o enseñan abstinencia sexual hasta el matrimonio—conceptos que frecuentemente son poco pertinentes para los YMSM. El no proveer educación para reducir los riesgos entre los YMSM implica que ellos no existen y se les niega "…instrucción acerca de cómo manejar sus vidas sexuales responsablemente."9,13

El uso de información homofóbica en la educación para la prevención del VIH/ETS es particularmente inquietante porque los esfuerzos de prevención que son realistos y balanceados pueden realizar cambios de comportamiento. Después de una intervención dirigida a los YMSM, el sexo anal sin protección disminuyó un 60% y el uso de condones para sexo anal aumentó un 50%.26

A pesar de que los YMSM suelen demostrar un buen conocimiento acerca de la transmisión del VIH, demasiados participan en actividades de alto riesgo.2,6 Esto evidencia que el conocimiento de por sí no produce cambios de comportamiento. Para ser efectiva, la prevención del VIH/ETS debe considerar los factores sociales y de desarrollo individual que conducen a los comportamientos de riesgo y desarrollar destrezas que traduzcan el conocimiento en cambios de comportamiento. Los siguientes componentes críticos para la prevención del VIH/ETS han sido obtenidos a través de estudios.

  • Adaptar los programas para incluir a los YMSM. Los programas desarrollados para todos los jóvenes deben abordar el tema de la orientación sexual e incluir discusiones acerca de sexo anal así como formas de reducir los riesgos de transmisión del VIH/ETS. Los programas deben incluir términos como "pareja sexual" y "comportamiento sexual con personas del mismo sexo." Además, los YMSM necesitan intervenciones diseñadas especialmente para ellos.
  • Involucrar a la juventud. Los grupos de apoyo entre pares proveen oportunidades—al margen de los encuentros sexuales—en que los YMSM pueden compartir sus emociones y experiencias, aliviar sus sentimientos de soledad y desarrollar sistemas de apoyo. Involucrar a los YMSM en el diseño e implementación de programas reduce sus comportamientos de riesgo y fomenta su espíritu de autodeterminación y autoestima.
  • Fomentar el sentido de valor propio. La prevención debe afirmar el valor de los YMSM y crear un contexto que fomente los comportamientos sexuales responsables. Las sesiones de consejería individual son muy efectivas al inicio de estas intervenciones.
  • Satisfacer las necesidades de los jóvenes. Poner atención en las necesidades identificadas por los YMSM, no por los adultos. Esto puede incluir: patrocinar grupos de apoyo, desarrollar destrezas para las relaciones de pareja, y proveerles de mentores u otros modelos de comportamiento.
  • Enseñar destrezas. Los programas deben enseñar destrezas. Las habilidades de usar condones, negociar sexo más seguro, construir relaciones, comunicarse con sus compañeros regulares o casuales, tomar decisiones y decir "no", fortalecen a los adolescentes para la toma decisiones saludables.27
  • Proveer apoyo constante. Como es difícil mantener los cambios de comportamiento, las poblaciones en alto riesgo requieren apoyo continuo y refuerzo. Para prevenir una recaída en comportamientos inseguros, los programas de prevención deben tomar en consideración que las necesidades de los YMSM cambian a medida que se van haciendo adultos.
  • Empezar temprano. Como el indicador más importante de los comportamientos de riesgo para la infección con VIH/ETS entre los jóvenes es su historia sexual, la prevención es más efectiva cuando se empieza antes de que comiencen a ser sexualmente activos.28,29 La prevención del VIH/ETS, que busca avanzar de acuerdo al desarrollo de los jóvenes, debe comenzar en la adolescencia temprana y apoyar tanto un comportamiento sexual responsable como conceptos saludables acerca de uno mismo. La educación sexual que se imparte en las escuelas puede reducir eficazmente los comportamientos sexuales de riesgo, sin aumentar la actividad sexual.
  • Crear programas dirigidos específicamente para los YMSM de color. Los estudios indican que los programas tienen que tomar en consideración los factores individuales, comunitarios y culturales que son pertinentes a los YMSM. Los programas deben abordar el tema del racismo en la comunidad homosexual blanca y, a la vez, apoyar a los YMSM de color a manejar sus decisiones acerca de su sexualidad, su identidad homosexual, su cultura y raza/etnia. Los YMSM necesitan un ambiente seguro para poder compartir sus experiencias.
  • Tomar en consideración las necesidades de los grupos marginados tales como los jóvenes sin hogar y los jóvenes abusados sexualmente. Los programas deben alcanzar a los jóvenes sin hogar, especialmente a los que están envueltos en prostitución, ya que es muy probable que no estén en la escuela. Los programas de alcance para educar a los YMSM sin hogar deben atender primero sus necesidades de alimentación, vestimiento y refugio. Sólo después de satisfacer estas necesidades se puede llamar su atención sobre asuntos relacionados con su salud sexual.

Pedro Zamora, quien murió en 1994 a la edad de 22 años, dijo acerca de las necesidades de los YMSM, "Yo necesitaba mensajes positivos acerca de mi sexualidad. Necesitaba saber de condones, cómo usarlos correctamente y dónde comprarlos. Necesitaba saber que uno puede ser sexual sin tener sexo. Necesitaba saber cómo decir 'No quiero tener sexo, sólo quiero que alguien me abrace.'"30

* En este Vistazo a un Tema, el término YMSM define a una categoría de hombres menores de 23 años que tienen sexo con otros hombres. Esta clasificación incluye a todos aquellos que se identifican a sí mismos como gays, homosexuales, bisexuales, heterosexuales, transgénero, así como a los que tienen dudas acerca de su identidad sexual.

Escrito por Deborah Roseman y Kent Klindera
Traducido y editado por Larry Villegas, Octubre de 2000

Bibliografía

  1. Martin AD, Hetrick ES. Designing an AIDS risk reduction program for gay teenagers: problems and proposed solutions. In: Ostrow DB, ed. Biobehavioral Approaches to the Control of AIDS. New York: Irvington, 1987.
  2. Sussman T. Duffy M. Are we forgetting about gay male adolescents in AIDS-related research and prevention? Youth & Society 1996; 27: 379-393.
  3. Lemp GF, Hirozawa AM, Givertz D, et al. Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. JAMA 1994; 272:449-454.
  4. Valleroy LA, MacKellar D, Janssen R. et al. HIV and Risk Behavior Prevalence among Young Men Who Have Sex with Men Sampled in Six Urban Counties in the USA. Presented at XI International Conference on AIDS, Vancouver, Canada, 1996.
  5. HIV Epidemiology Program, Los Angeles County Dept. of Health. Young Men's Survey: Los Angeles, Aug. 1994- Jan. 1996. Presented to Los-Angeles County Adolescent HIV Consortium, Los Angeles, CA, 1996.
  6. Remafedi G. Predictors of unprotected intercourse among gay and bisexual youth: knowledge, beliefs, and behavior. Pediatrics 1994; 94:163-68.
  7. Smith C, duBay K, Langenbahn S. Young men who have sex with men: findings from questionnaires, focus groups and interviews in Massachusetts. [s.l.]: Abt Associates, 1996.
  8. Shoop DM, Davidson PM. AIDS and adolescents: the relation of parent and partner communication to adolescent condom use. JAdolesc 1994; 17:137-148.
  9. American Health Consultants. Program dedicated to gay adolescents fills support gap. AIDS Alert 1993; 8:188-189.
  10. Telljohann SK, Price JH, Poureslami M, et al. Teaching about sexual orientation by secondary health teachers. JSch Health 1995; 65:18-22.
  11. Valleroy L. The Prevalence and Predictors of Unprotected Receptive Anal Intercourse for 15- to 22-year-old Men Who Have Sex with Men in Seven Urban Areas, U.S.A. Presented at the XII International Conference on AIDS, Geneva, Switzerland, 1998.
  12. Hays RB. What Are Young Gay Men's HIV Prevention Needs? San Francisco: Center for AIDS Prevention Studies, University of California, 1996.
  13. Cranston K. HIV education for gay, lesbian, and bisexual youth: personal risk, personal power, and the community of conscience. In: Coming Out of the Classroom Closet. Binghamton, NY: Haworth, 1992.
  14. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report 1997; 9(2):1-43.
  15. Hetrick-Martin Institute. Lesbian, Gay, and Bisexual Youth. [Fact File] New York: The Institute, 1992.
  16. Green J. Flirting with suicide. The New York Times Magazine 1996; Sept. 15: 39-44+.
  17. Macieira M, Messina S. The invisible minority: lesbian and gay youth. PSAYNetwork 1994; 2(1):7-8.
  18. Grossman A. Homophobia: a cofactor of HIV disease in gay and lesbian youth. JANAC 1994; 5(1):39-40.
  19. American Health Consultants. Peer education, reduction of risk appeal to gay teens. AIDS Alert 1995;10:131-132.
  20. Rotheram-Borus MJ, Reid H. Rosario M, et al. Determinants of safer sex patterns among gay/bisexual male adolescents. JAdolesc 1995; 18-3-15.
  21. American Health Consultants. New generation of gay men not heeding safe-sex warnings. AlDS Alert 1994; 9:151- 153.
  22. US Conference of Mayors. Safer sex relapse: a contemporary challenge. AIDS Information Exch 1994; 11(4):1-8.
  23. Beeker C, Kraft JM, Peterson JL, et al. Influences on sexual risk behavior in young African American men who have sex with men. J Gay & Lesbian Medical Assoc 1998; 2:59-67.
  24. Choi KH, Yap GA, Kumekawa E. HIV prevention among Asian and Pacific Islander men who have sex with men: a critical review of theoretical models and directions for future research. AIDS Educ Prev 1998; 10 (Suppl A):19-30.
  25. Remafedi G. The impact of training on school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality. JSch Health 1993; 63:153-157.
  26. Remafedi G. Cognitive and behavioral adaptations to HIV/AIDS among gay and bisexual adolescents. J Adolesc Health 1994; 15:142-148.
  27. National Commission on AIDS. Preventing HIV/AIDS in adolescents. JSch Health 1994; 64:39-51.
  28. Rotheram-Borus MJ, Reid H. Rosario M. Factors mediating changes in sexual HIV risk behaviors among gay and bisexual male adolescents. Am J Public Health 1994;84:1938-1946.
  29. Stryker J. Coates TJ, DeCarlo P. et al. Prevention of HIV infection: looking back, looking ahead. JAMA 1995; 273:1143-1148.
  30. Coates T, DeCarlo P. For Pedro: a Rededication to Helping Young Gay Men Stay Safe. San Francisco: Center for AIDS Prevention Studies, University of California, 1996.

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Parent-Child Communication Basics Print

An Education Program to Enhance Parent-Child Communication

Research indicates that strong family relationships can help children develop self-esteem, resist peer pressure, and act responsibly when making decisions about drugs, violence, and sexual intercourse. Effective parent-child communication is a cornerstone of strong and healthy families. In the era of HIV/AIDS, parents must learn ways to communicate more effectively with their young people. How and what they communicate about body image, peer pressure, puberty, reproduction, sexuality, love, and intimacy can make a significant difference in the health and well-being of their children.

This notebook contains all of the materials needed to conduct a 75-minute, introductory seminar on general parent-child communication.

Table of Contents

 

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Executive Summary: Science and Success, Second Edition Print

Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections

Full Study Report [HTML] [PDF]
Executive Summary [PDF]
Order publication online.

Until recently, teen pregnancy and birth rates had declined in the United States. Despite these declines, US teen birth and sexually transmitted infection (STI) rates remain among the highest in the industrialized world. Given the need to focus limited prevention resources on effective programs, Advocates for Youth undertook exhaustive reviews of existing research to compile a list of those programs proven effective by rigorous evaluation. Nineteen programs appeared in Science and Success when it was first published in 2003; seven additional programs are included in Science and Success, Second Edition.

Criteria for Inclusion—The programs included in this document all had evaluations that:

  • Were published in peer-reviewed journals (a proxy for the quality of the evaluation design and analysis);
  • Used an experimental or quasi-experimental evaluation design, with treatment and control / comparison conditions;
  • Included at least 100 young people in treatment and control / comparison groups.

Further, the evaluations either:

  • Continued to collect data from both groups at three months or later after intervention

And

  • Demonstrated that the program led to at least two positive behavior changes among program youth, relative to controls:
    • Postponement or delay of sexual initiation;
    • Reduction in the frequency of sexual intercourse;
    • Reduction in the number of sexual partners / increase in monogamy;
    • Increase in the use, or consistency of use, of effective methods of contraception and/or condoms;
    • Reduction in the incidence of unprotected sex.

Or:

  • Showed effectiveness in reducing rates of pregnancy, STIs, or HIV in intervention youth, relative to controls.

Program Effects—Twenty-six programs met the criteria described above: these 26 programs were able to affect the behaviors and/or sexual health outcomes of youth exposed to the program.

Risk Avoidance Through Abstinence—Fourteen programs demonstrated a statistically significant delay in the timing of first sex among program youth, relative to comparison / control youth. One of these programs is an intervention for elementary school children and their parents. The other 13 programs target middle and high school youth and all include information about both abstinence and contraception, among other topics and/or services. (See Table A)

Risk Reduction for Sexually Active Youth—Many of the programs also demonstrated reductions in other sexual risk-taking behaviors among participants relative to comparison / control youth. (See Table A)

  • 14 programs helped sexually active youth to increase their use of condoms.
  • 9 programs demonstrated success at increasing use of contraception other than condoms.
  • 13 programs showed reductions in the number of sex partners and/or increased monogamy among program participants.
  • 7 programs assisted sexually active youth to reduce the frequency of sexual intercourse.
  • 10 programs helped sexually active youth to reduce the incidence of unprotected sex.

Reduced Rates of Teenage Pregnancy or Sexually Transmitted Infections—Thirteen programs showed statistically significant declines in teen pregnancy, HIV or other STIs. Nine demonstrated a statistically significant impact on teenage pregnancy among program participants and four, a reduced trend in STIs among participants when measured against comparison / control youth.(See Table A)

Increased Receipt of Health Care or Increased Compliance with Treatment Protocols—Six programs achieved improvements in youth’s receipt of health care and//or compliance with treatment protocols, or other actions that improved their health. (See Table A)

Program Content—Of the 26 effective programs described here, 23 included information about abstinence and contraception within the context of sexual health education. Of the three that did not include sexual health education, two were early childhood interventions and one was a service-learning program.

I. School Based Programs

1. AIDS Prevention for Adolescents in School
This HIV/STI prevention curriculum comprises six sessions, delivered on consecutive days, and includes experiential activities to build skills in refusal, risk assessment, and risk reduction. It is recommended for use with African American, Hispanic, white, and Asian high school students in urban settings. Evaluation found that this program assisted sexually experienced participants to increase monogamy, reduce the number of their drug-using sexual partners, and increase condom use. The program had no significant effect on delaying the initiation of sex. Evaluation found the program to be associated with a favorable trend in the incidence of STIs among participants, relative to controls.[1]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

2. Get Real about AIDS
This HIV risk reduction curriculum comprises 15 sessions delivered over consecutive days. It includes experiential activities to build skills in refusal, communication, and condom use. Other components include activities, such as public service announcements, to reach more youth and reinforce educational messages. It is recommended for use with sexually active, white and Hispanic, urban, suburban, and rural, high school students. Evaluation found that the program assisted sexually active participants to reduce the number of their sexual partners, increase condom use, and increase condom purchase. The program did not affect the timing of sexual initiation. It did not reduce the frequency of sex among sexually active youth nor their use of drugs and alcohol prior to having sex.[2]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

3. Postponing Sexual Involvement (Augmenting a Five-Session Human Sexuality Curriculum)
This five-session, peer-led curriculum is designed to augment a five-session human sexuality curriculum led by health professionals, who also refer sexually active youth for nearby reproductive health care. It is recommended for use with eighth grade, black urban youth, especially those at socioeconomic disadvantage. Evaluation showed delayed initiation of sexual intercourse and, among sexually experienced participants, reduced frequency of sex and increased use of contraception. When replicated without fidelity (including omission of the five-session human sexuality curriculum), the program led to no changes in sexual behavior among participants relative to comparison youth.[3,4,5]

For More Information or to Order Postponing Sexual Involvement to Augment Human Sexuality Education, Contact

  • Marian Apomah, Coordinator, Jane Fonda Center; Emory Unversity School of Medicine: Building A Briarcliff Campus, 1256 Briarcliff Road, Atlanta, GA, 30306; Phone, 404.712.4710; Fax, 404.712.8739

4. Postponing Sexual Involvement, Human Sexuality & Health Screening
This pregnancy prevention program combines the five-session, peer-led Postponing Sexual Involvement curriculum with elements drawn from the Self Center (described below), and includes: three classroom sessions on reproductive health, delivered to seventh graders by health professionals and, again the next year, to eighth graders; group discussions; and a full-time health professional from outside the school and working in the school. Other components of the program include individual health risk screening and an eighth grade assembly and contest. The program is recommended for seventh and eighth grade, urban, African American, economically disadvantaged females. Evaluation found that the program assisted female participants to delay initiation of sexual intercourse and increased the use of contraception by sexually active female participants. Evaluation found no statistically significant impact on the sexual behaviors of male participants.[6]

For More Information or to Order, Contact

  • Renee R. Jenkins, MD, Dept. of Pediatrics and Child Health, Howard University Hospital: 2041 Georgia Avenue NW, Washington, DC 20060
  • For Postponing Sexual Involvement— Marian Apomah, Coordinator, Jane Fonda Center; Emory Unversity School of Medicine: Building A Briarcliff Campus, 1256 Briarcliff Road, Atlanta, GA, 30306; Phone, 404.712.4710; Fax, 404.712.8739
  • For the Self Center— Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

5. Reach for Health Community Youth Service
This program combines a health promotion curriculum (40 lessons per year in each of two years), including sexual health information, with three hours per week of community service. Activities help students reflect on and learn from their community experience. The program is recommended for use with seventh and eighth grade, urban, black, and Hispanic youth, especially those who are economically disadvantaged. Evaluation showed delayed initiation of sexual intercourse, an effect that continued even through 10th grade. The program also assisted sexually active participants in reducing the frequency of sex and increasing use of condoms and contraception.[7]

For More Information or to order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

6. Reducing the Risk (RTR)
Reducing the Risk is a sex education curriculum, including information on abstinence and contraception. In 16, 45-minute sessions, it offers experiential activities to build skills in refusal, negotiation, and communication, including that between parents and their children. Designed for use with high school students, especially those in grades nine and 10, it is recommended for use with sexually inexperienced, urban, suburban, and rural youth—white, Latino, Asian, and black. Evaluation showed that it was more effective with lower risk, than with higher risk, youth. Evaluations—of the original program and of a replication of the program—each found: increased parent-child communication about abstinence and contraception; delayed initiation of sexual intercourse; and reduced incidence of unprotected sex / increased use of contraception among participants as well.[8,9]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com
  • ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org/

7. Safer Choices
This is an HIV/STI and teen pregnancy prevention curriculum, given in 20 sessions, evenly divided over two years and designed for use with grades nine through 12. The program includes experiential activities to: build skills in communication; delay the initiation of sex; and promote condom use by sexually active participants. Other elements include a school health protection council, a peer team or club to host school-wide activities, educational activities for parents, and HIV-positive speakers. The program is recommended for use with Hispanic, white, African American, and Asian, urban and suburban high school students. A new evaluation showed that Safer Choices effectively assisted sexually inexperienced youth, especially Hispanics, to delay the initiation of sexual intercourse. It assisted sexually experienced youth to reduce the number of new sex partners, reduce the incidence of unprotected sex, and increase use of condoms and other contraception. Earlier evaluation showed that Safer Choices assisted sexually experienced youth to increase condom and contraceptive use. Earlier evaluation also showed that hearing an HIV-positive speaker was associated with participants' greater likelihood of receiving HIV testing, relative to control youth.[11,12,13,14]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com
  • ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org/

8. School/Community Program for Sexual Risk Reduction among Teens
This intensive, school-based intervention integrates sex education into a broad spectrum of courses throughout public education (kindergarten through 12th grade). It includes teacher training, peer education, school-based health clinic services (including contraceptive provision), referral and transportation to community-based reproductive health care, workshops to develop the role modeling skills of parents and community leaders, and media coverage of a spectrum of health topics. The program is recommended for use with black and white rural students (kindergarten through 12th grade). Evaluation found that this program reduced teen pregnancy rates in the participating community relative to comparison counties. Replication in two counties in another state found that it assisted youth in one county to delay the initiation of sexual intercourse and assisted males in another county to increase their use of condoms, relative to youth in comparison counties.[15,16,17]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

9. Seattle Social Development Project
This is a school-based program to provide developmentally appropriate, social competence training to elementary school children. Components include educator training each year and voluntary parenting classes on encouraging children's developmentally appropriate social skills. The program is recommended for use with urban, socio-economically disadvantaged children—white, Asian, and Native American, but especially African American—in grades one through six. Evaluation when study participants were age 18, and again when they reached 21, found that the program assisted youth who participated in the program as children to significantly delay the initiation of sexual intercourse and, among sexually experienced youth, to reduce the number of sexual partners and increase condom use, relative to comparison youth. By age 21, the program also showed reduced rates of teenage pregnancy and birth in participants, relative to comparison youth. Other long-term positive outcomes for participating youth, relative to comparisons, included increased academic achievement and reduced incidence of delinquency, violence, school misbehavior, and heavy drinking.[18,19]

For More Information, Contact

  • Social Development Research Group, University of Washington: 9725 Third Avenue NE, Suite 401, Seattle, Washington, 98115

    This program is not available for purchase

10. Self-Center (School-Linked Reproductive Health Center)
This model of the school-linked health center (SLHC) offers free reproductive and contraceptive health care to participating youth from nearby junior and senior high schools. SLHC staff works daily in participating schools, providing sex education lessons once or twice a year in each homeroom and offering daily individual and group counseling in the school health suite. Staff is also available daily in the SLHC to provide students with education and counseling and, for those youth registered with the clinic, reproductive and sexual health care. The program is recommended for use with urban, black, and economically disadvantaged, junior and senior high school students. Evaluation found that the program assisted participants to delay the initiation of sexual intercourse and to use reproductive health services prior to initiating sex. It also assisted sexually active participants to reduce the incidence of unprotected sex and increase their use of contraception. The program resulted in a reduction in teen pregnancy rates among participants, relative to comparison youth.[20,21]

For More Information or to order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

11. Teen Outreach Project (TOP)
This school-based, teen pregnancy and dropout prevention program involves weekly school classes, lasting one hour, that integrate the developmental tasks of adolescence with lessons learned from community service (lasting at least 30 minutes each week). The curriculum focuses on values, human growth and development, relationships, dealing with family stress, and issues related to the social and emotional transition from adolescence to adulthood. The program is recommended for high school youth at risk of teen pregnancy, academic problems, and school dropout, and is most effective with ethnic minority youth, adolescent mothers, and students with academic difficulties, including previous school suspension. Evaluation of the original program and evaluations of two replications all found that the program reduced rates of pregnancy, school suspension, and class failure among participants, relative to control/comparison youth.[22,23,24]

For More Information or to Order, Contact

  • Wyman Teen Outreach Program: 600 Kiwanis Drive, Eureka, MO 63025; Phone, 636-549-1236;
    E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ;
    Web, http://www.wymancenter.org.

Section II. Community-Based Programs

12. Abecedarian Project
This full-time educational program consists of high quality childcare from infancy through age five, including individualized games that focus on social, emotional, and cognitive development, with a particular emphasis on language. During the early elementary school years, the program works to involve parents in their children's education, using a Home School Resource Teacher to serve as a liaison between school and families. The program is recommended for use with healthy, African American infants from families that meet federal poverty guidelines. Evaluation found long-term impacts, including a reduced number of adolescent births and delayed first births as well as increased rates of skilled employment and college education and reduced rates of marijuana use among former participants, relative to controls.[25]

For More Information, Contact

  • FPG Child Development Institute, University of North Carolina at Chapel Hill: http://www.fpg.unc.edu/~abc/
    This program is not available for purchase.

13. Adolescents Living Safely: AIDS Awareness, Attitudes & Actions
This HIV prevention program is designed to augment traditional services available at shelters for runaway youth. The program involves 30 discussion sessions for small groups, each lasting one-and-a-half to two hours and including experiential activities to build cognitive and coping skills. Intensive training of shelter staff and access to health care, including mental health services, are also important components of the program. It is recommended for use with black and Hispanic runaway youth, ages 11 through 18, living in city shelters. Evaluation found that the program assisted youth to reduce the frequency of sex and numbers of sexual partners, and to increase condom use. The program did not affect the timing of sexual initiation.[26]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com.

14. Be Proud! Be Responsible! A Safer Sex Curriculum
This HIV prevention curriculum comprises six sessions, each lasting 50 minutes, and includes experiential activities to build skills in negotiation, refusal, and condom use. It is recommended for use with urban, black, male youth, ages 13 through 18. Evaluation found that it assisted young men to reduce their frequency of sex, reduce the number of their sexual partners (especially female partners who were also involved with other men), increase condom use, and reduce the incidence of heterosexual anal intercourse.[27,28]

For More Information or to Order, Contact

15. Becoming a Responsible Teen
This HIV prevention, sex education, and skills training curriculum comprises eight one-and-a-half- to two-hour sessions. It includes experiential activities to build skills in assertion, refusal, problem solving, risk recognition, and condom use and is designed for use in single-sex groups, each facilitated by both a male and a female leader. It is recommended for use with African American youth, ages 14 through 18. Evaluation found the program assisted participants to delay the initiation of sex and assisted sexually active participants to reduce the frequency of sex, decrease the incidence of unprotected sex (including anal sex), and increase condom use.[29]

For More Information or to Order, Contact

16. California’s Adolescent Sibling Pregnancy Prevention Project
This teen pregnancy prevention program provides individualized case management and care as well as sex education, including information on abstinence and contraception, to the adolescent siblings of pregnant and parenting teens. The program is recommended for economically disadvantaged, Hispanic youth, ages 11 to 17. Evaluation found that the program assisted female youth to delay the initiation of sexual intercourse and assisted male youth to increase the consistent use of contraception. The program resulted in reductions in teen pregnancy rates among program youth, relative to comparison youth.[30]

For More Information, Contact

  • California Department of Health Services, Maternal & Child Health Branch: 714 P Street, Room 750, Sacramento, CA 95814; Phone: 1.866. 241.0395

    This program is not available for purchase.

17. Children’s Aid Society—Carrera Program
This multi-component youth development program provides daily after-school activities—including a job club and career exploration, academic tutoring and assistance, sex education that includes information about abstinence and contraception, arts workshops, and individual sports activities. A summer program offers enrichment activities, employment assistance, and tutoring. The program provides year-round, comprehensive health care, including primary, mental, dental, and reproductive health services. The program involves youth's families and provides interpersonal skills development and access to a wide range of social services. The program is recommended for use with urban, black and Hispanic, socio-economically disadvantaged youth, ages 13 through 15. Evaluation found that the program assisted female participants to delay the initiation of sexual intercourse and resist sexual pressure. It also assisted sexually experienced female participants to increase their use of dual methods of contraception. The program assisted both male and female participants to increase their receipt of health care. Otherwise, evaluation showed no positive, significant behavioral changes in participating males relative to comparison males. The program resulted in reduced rates of teen pregnancy among participants, relative to comparison youth.[31]

For More Information, Contact

18. Community Level HIV Prevention Intervention for Adolescents in Low-Income Developments
This HIV prevention program includes training in refusal, condom negotiation, communication, and condom use for adolescents in low-income housing developments. Workshops are followed by a multi-component community intervention including follow-up sessions; a Teen Health Project Leadership Council; media projects, social events, talent shows, musical performances, and festivals; and HIV/AIDS workshops for parents. The program is recommended for low-income adolescents living in housing projects, urban youth, and multi-ethnic youth ages 12-17. Evaluation found that the program assisted participants to delay initiation of sex and assisted sexually active participants to increase condom use.[32]

For More Information, Contact

19. ¡Cuidate!
This HIV prevention curriculum is tailored for use with Latino adolescents. Its goals are to 1) influence attitudes, beliefs, and self-efficacy regarding HIV risk reduction, especially abstinence and condom use; 2) highlight cultural values that support safer sex practices; 3) reframe cultural values that might be perceived as barriers to safer sex; and 4) emphasize how cultural values influence attitudes and beliefs in ways that affect sexual risk behaviors. It consists of six one-hour modules delivered over consecutive days. The program is recommended for urban Latino youth ages 13-18. Evaluation found that the program assisted participants to reduce frequency of sex, reduce number of sex partners, reduce incidence of unprotected sex, and increase condom use.[33,34]

For More Information, Contact

  • Antonia M. Villarruel at the University of Michigan School of Nursing, 400 N. Ingalls, Suite 4320, Ann Arbor, MI, 48109-0482. Phone: 734-615-9696. E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

20. Making Proud Choices!
This HIV prevention curriculum emphasizes safer sex and includes information about both abstinence and condoms. It comprises eight, culturally appropriate sessions, each lasting 60 minutes and includes experiential activities to build skills in delaying the initiation of sex, communicating with partners, and among sexually active youth, using condoms. It is recommended for use with urban, African American youth, ages 11 through 13. Evaluation found the program assisted participants to delay initiation of sex and assisted sexually active participants to reduce the frequency of sex, reduce the incidence of unprotected sex, and increase condom use.[35]

For More Information or to Order, Contact

21. Poder Latino: A Community AIDS Prevention Program for Inner-City Latino Youth
This community-wide, 18-month program provides peer education workshops on HIV awareness and prevention and peer-led group discussions in various community settings. Peer educators also lead efforts to make condoms available via door-to-door and street canvassing and make presentations at major community events. Radio and television public service announcements, posters in local businesses and public transit, and a newsletter augment the work of the peer educators. The program is designed for use in urban, Latino communities in order to reach the community’s adolescents ages 14 through 19. Evaluation showed that the program assisted the community's male teens to delay the initiation of sexual intercourse and assisted the community's sexually active female teens to reduce the number of their sexual partners. The program did not affect sexually active participants' frequency of sex.[36,37]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com

Section III. Clinic-Based Programs

22. HIV Risk Reduction for African American & Latina Adolescent Women
This skills-based HIV risk reduction intervention is designed for use in health clinics. Intended for use with African American and Latina young women, ages up to 19, who are at high risk of HIV because they have prior STI infections, the program provides young clients with confidential and free family planning services, teaches them how to use condoms, and provides skill building in relation to partner negotiation and condom use. Evaluation found that young women who participated in the intervention had a lower incidence of STIs versus comparisons; they also reduced the number of their sexual partners and their incidence of unprotected sex.[38]

For More Information or to Order, Contact

  • Loretta Sweet Jemmott, PhD, FAAN, RN, School of Nursing, University of Pennsylvania, Room 239 Fagin Hall, 418 Curie Blvd., Philadelphia, Pennsylvania 19104-6096; Phone, 215.898.8287; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

There is little replication information available for this program.

23. Project SAFE (Sexual Awareness for Everyone)
This gender- and culture-specific behavioral intervention consists of three sessions, each lasting three to four hours. Designed specifically for young African American and Latina women ages 15 through 24, it actively involves participants in lively and open discussion and games, videos, role plays, and behavior modeling. Discussions cover abstinence, mutual monogamy, correct and consistent condom use, compliance with STI treatment protocols, and reducing the number of one’s sex partners. Each participant is encouraged to identify realistic risk reduction strategies that she can use in the context of her own life and values. Evaluation found that participants increased their adherence to monogamy, reduced the number of their sexual partners and the incidence of unprotected sex, reduced the incidence of STIs, and increased their compliance with STI treatment protocols.[39,40,41,42]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com.

24. SiHLE
SiHLE is an HIV prevention program especially designed for sexually active African American teenage women. Consisting of four sessions, each lasting four hours, the program is facilitated by trained, African American females—one health educator and two peer educators. Sihle means beautiful or strong young woman, and the program encourages participants to develop ethnic and gender pride as well as self-confidence. It also builds their skills and awareness for sexual risk reduction. Evaluation found increased condom use and reduced number of new sex partners as well as reduced incidence of: unprotected sex; STIs, and pregnancy.[43]

For More Information or to order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com.

25. Tailoring Family Planning Services to the Special Needs of Adolescents
This effective, clinic-based, pregnancy prevention protocol is designed for use in family planning and other reproductive and sexual health clinics. It is particularly designed to meet the special needs of youth under the age of 18. As such, it provides education geared to the adolescent’s cognitive development and offers reassurance of confidentiality, extra time for counseling, information and reassurance regarding medical exams, and carefully timed medical services. Evaluation found that teens that had these specially tailored services were significantly more likely than other teens to increase their use of effective contraception and had a decreased pregnancy rate.[44]

For More Information or to Order, Contact

  • Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com.

26. TLC: Together Learning Choices
This curriculum is aimed at HIV positive youth in a clinic setting. It consists of 16 sessions of a small group intervention led by trained facilitators. Participants learn skills in solving problems, setting goals, communicating effectively, being assertive, and negotiating safer sex practices. They also improve their self-awareness regarding their feelings, thoughts, and beliefs, especially related to health promotion and positive social interactions. The program can be used with urban, African American or Latino, HIV-positive youth ages 13 through twenty-four. Evaluation found that the program assisted participants to reduce numbers of sexual partners, reduce incidence of unprotected sex, increase positive lifestyle changes (females only), and increase positive coping actions.[45,46]

For More Information, Contact

For the full document - Science & Success, Second Edition: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections, please visit www.advocatesforyouth.org/programsthatwork/toc.htm.

Written by Sue Alford, MLS
Advocates for Youth © 2008

References

  1. Walter HJ, Vaughan RD. AIDS risk reduction among a multiethnic sample of urban high school students. JAMA 1993; 270:725-730.
  2. Main DS, Iverson DC, McGloin J et al. Preventing HIV infection among adolescents: evaluation of a school-based education program. Preventive Medicine 1994; 23:409-417.
  3. Howard M, McCabe JB. Helping teenagers postpone sexual involvement. Family Planning Perspectives 1990; 22:21-26.
  4. Kirby D, Korpi M, Barth RP et al. The impact of the Postponing Sexual Involvement curriculum among youths in California. Family Planning Perspectives 1997; 29:100-108.
  5. Cagampang HH, Barth RP, Korpi M et al. Education Now and Babies Later (ENABL): life history of a campaign to postpone sexual involvement. Family Planning Perspectives 1997; 29:109-114.
  6. Aarons SJ, Jenkins RR, Raine TR et al. Postponing sexual intercourse among urban junior high school students—a randomized controlled evaluation. Journal of Adolescent Health 2000; 27:236-247.
  7. O'Donnell L, Stueve A, San Doval, A et al. The effectiveness of the Reach for Health Community Youth Service learning program in reducing early and unprotected sex among urban middle school students. American Journal of Public Health 1999; 89:176-181.
  8. O'Donnell L, Stueve A, O'Donnell C et al. Long-term reductions in sexual initiation and sexual activity among urban middle schoolers in the Reach for Health service learning program. Journal of Adolescent Health 2002; 31:93-100.
  9. Kirby D, Barth RP, Leland N et al. Reducing the Risk: impact of a new curriculum on sexual risk-taking. Family Planning Perspectives 1991; 23:253-263.
  10. Hubbard BM, Giese ML, Rainey J. A replication study of Reducing the Risk, a theory-based sexuality curriculum for adolescents. Journal of School Health 1998; 68:243-247.
  11. Coyle K, Basen-Engquist K, Kirby D et al. Short-term impact of Safer Choices: a multicomponent, school-based HIV, other STD, and pregnancy prevention program. Journal of School Health 1999; 69:181-188.
  12. Coyle K, Basen-Engquist K, Kirby D et al. Safer Choices: reducing teen pregnancy. HIV, and STDs. Public Health Reports 2001; 116 (Supplement 1):82-93.
  13. Kirby D, Baumler E, Coyle K et al. The Safer Choices intervention: its impact on the sexual behaviors of different subgroups of high school students. Journal of Adolescent Health 2004; 35:442-452.
  14. Markham C, Baumler E, Richesson R et al. Impact of HIV-positive speakers in a multicomponent, school-based HIV / STD prevention program for inner-city adolescents. i; 12:442-454.
  15. Vincent ML, Clearie AF, Schluchter MD. Reducing adolescent pregnancy through school and community-based education. i; 257:3382-3386.
  16. Koo HP, Dunteman GH, George C et al. Reducing adolescent pregnancy through a school- and community-based intervention: Denmark, South Carolina, revisited. Family Planning Perspectives 1994; 26:206-211.
  17. Paine-Andrews A, Harris KJ, Fisher JL et al. Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities. Family Planning Perspectives 1999; 31:182-189.
  18. Lonczak HS, Abbott RD, Hawkins JD et al. Effects of the Seattle Social Development Project on sexual behavior, pregnancy, on sexual behavior, pregnancy, birth, and sexually transmitted disease outcomes by age 21 years. Archives of Pediatrics & Adolescent Medicine 2002; 156:438-447.
  19. Hawkins JD, Catalano RF, Kosterman R et al. Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatrics & Adolescent Medicine 1999; 153:226-234.
  20. Zabin LS, Hirsch MB, Smith EA et al. Evaluation of a pregnancy prevention program for urban teenagers. Family Planning Perspectives 1986; 18:119-126.
  21. Frost JJ, Forrest JD. Understanding the impact of effective teenage pregnancy prevention programs. Family Planning Perspectives 1995; 27:188-195.
  22. Allen JP, Philliber S, Hoggson N. School-based prevention of teen-age pregnancy and school dropout: process evaluation of the national replication of the Teen Outreach Program. American Journal of Community Psychology 1990; 18:505-523.
  23. Allen JP, Philliber S, Herrling S et al. Preventing teen pregnancy and academic failure: experimental evaluation of a developmentally-based approach. Child Development 1997; 64:729-742.
  24. Allen JP, Philliber S. Who benefits most from a broadly targeted prevention program? Differential efficacy across populations in the Teen Outreach Program. Journal of Community Psychology 2001; 29:637-655.
  25. Campbell FA, Ramey CT, Pungello E et al. Early childhood education: young adult outcomes from the Abecedarian Project. Applied Developmental Science 2002; 6(1):42-57.
  26. Rotheram-Borus MJ, Koopman C, Haignere C et al. Reducing HIV sexual risk behaviors among runaway adolescents. JAMA 1991; 266:1237-1241.
  27. Jemmott JB, Jemmott LS, Fong GT. Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention. American Journal of Public Health 1992; 82:372-377.
  28. ETR Associates. Be Proud! Be Responsible! Programs that Work. http://www.etr.org/recapp/programs/proud.htm.
  29. St. Lawrence JS, Brasfield TL, Jefferson KW et al. Cognitive-behavioral intervention to reduce African American adolescents' risk for HIV infection. Journal of Consulting and Clinical Psychology 1995; 63:221-237
  30. East P, Kiernan E, Chavez G. An evaluation of California's Adolescent Sibling Pregnancy Prevention Program. Perspectives on Sexual & Reproductive Health 2003; 35:62-70.
  31. Philliber S, Williams Kaye J, Herrling S et al. Preventing pregnancy and improving health care access among teenagers: an evaluation of the Children's Aid Society—Carrera Program. Perspectives on Sexual & Reproductive Health 2002; 34:244-251.
  32. Sikkema KJ, Anderson ES, Kelly JA et al. Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments. AIDS 2005; 19:1509-1516.
  33. Villarruel AN, Jemmott JB, Jemmott LS. A randomized controlled trial testing an HIV prevention intervention for Latino youth. Archives of Pediatrics & Adolescent Medicine 1006; 160:772-777.
  34. Centers for Disease Control & Prevention. ¡Cuidate! A Culturally-based Program to Reduce HIV Sexual Risk Behavior among Latino Youth; http://www.cdc.gov/hiv/topics/prev_prog/rep/packages/!cuidate!.htm; accessed 11/16/2007.
  35. Jemmott JB, Jemmott LS, Fong GT. Abstinence and safer sex HIV risk-reduction interventions for African American adolescents: a randomized controlled trial. JAMA 1998; 279:1529-1536.
  36. Sellers DE, McGraw SA, McKinlay JB. Does the promotion and distribution of condoms increase teen sexual activity? Evidence from an HIV prevention program for Latino youth. American Journal of Public Health 1994; 84:1952-1959.
  37. Smith KW, McGraw SA, Crawford SL et al. HIV risk among Latino adolescents in two New England cities. American Journal of Public Health 1993; 83:1395-1399.
  38. Jemmott JB, Jemmott LS, Braverman PK et al. HIV/STD risk reduction interventions for African American and Latino adolescent girls at an adolescent medicine clinic. Archives of Pediatrics & Adolescent Medicine 2005; 159:440-449.
  39. Shain RN, Piper JM, Newton ER et al. A randomized controlled trial of a behavioral intervention to prevent sexually transmitted diseases among minority women. New England Journal of Medicine 1999; 340(2):93-100.
  40. Shain RN, Piper JM, Holden AEC et al. Prevention of gonorrhea and chlamydia through behavioral intervention: results of a two-year controlled randomized trial in minority women. Sexually Transmitted Diseases 2004; 31(7):401-408.
  41. Shain RN, Perdue ST, Piper JM et al. Behaviors changed by intervention are associated with reduced STD recurrence: the importance of context in measurement. Sexually Transmitted Diseases 2002; 29:520-529.
  42. Korte JE, Shain RN, Holden AEC et al. Reduction in sexual risk behaviors and infection rates among African Americans and Mexican Americans. Sexually Transmitted Diseases 2004; 31:166-173.
  43. DiClemente RJ, Wingood GM, Harrington KF et al. Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial. JAMA 2004; 292:171-179.
  44. Winter L, Breckenmaker LC. Tailoring family planning services to the special needs of adolescents. Family Planning Perspectives 1991; 23:24-30.
  45. Rotheram-Borus MJ, Lee MB, Murphy DA et al. Efficacy of a preventive intervention for youths living with HIV. American Journal of Public Health 2001; 91:400-405.
  46. Centers for Disease Control & Prevention. TLC: Together Learning Choices: A Small Group Level Intervention with Young People Living with HIV/AIDS; http://www.cdc.gov/hiv/topics/prev_prog/rep/packages/TLC.htm; accessed 11/16/2007.
This publication is part of Science and Success, Programs that Work series.
 
Working with GLBTQ Youth Print

Volume 14, No. 4, June 2002

This Transitions is also available in [PDF] format.

Table of Contents

This issue of Transitions offers factual information about the lives of and risks to gay, lesbian, bisexual, transgender, and questioning (GLTBQ) youth, as well as personal observations of young activists in the field. It provides criteria for successfully serving GLBTQ youth, GLBTQ youth of color, HIV-positive youth, transgender youth, and young people who question their sexual orientation. It addresses the chilling effect of abstinence-only-until-marriage education and the need of lesbian and bisexual young women for access to emergency contraception. Throughout the issue, GLBTQ youth give glimpses of their lives, perceptions, personalities, and experiences.

Advocates for Youth's Online Interventions by Youth for Youth

  • YouthResource (http://www.youthresource.com/) is created by and for GLBTQ youth ages 13 to 24 and takes a holistic approach to sexual health by offering support, community, resources, and peer-to-peer education about issues of concern to GLBTQ youth.
  • Ambiente Joven (http://www.ambientejoven.org/) is a Web site for Latino/Latina YMSM and GLBTQ youth and provides information on safer sex, HIV/AIDS, and mental and sexual health through peer educators based in the United States and Latin America.
  • MySistahs (http://www.mysistahs.org) is created by and for young women of color and provides holistic sexual health information.

Resources

Films by Teens for Teens

Scenarios USA is a program for teenagers to get them thinking about their choices and decisions around important issues that affect their lives, such as HIV/AIDS, unwanted pregnancy and violence. Teens, ages 12 to 22, address these issues by writing stories for the Scenarios contest, What's the Real Deal.

Winners get to make their stories into short films in their hometown, working with a professional filmmaker and crew. The finished products are high-quality short films that educators can use to spark discussion on important issues. The films have been shown on MTV, PBS and NBC affiliates, Oxygen, at film festivals and on the Internet as well as on ABC's World News Tonight and NPR's On the Media.

Scenarios USA introduces a new film in the series. Lipstick is a story about a group of teenage best friends, the courage of one girl to express who she is, and the struggle of another to accept and understand difference. Together, the four friends confront fears and prejudice, and friendship prevails. Lipstick deals forthrightly and understandingly with sexual identity, self-expression, and acceptance.

Lipstick is available for purchase beginning mid-June 2002 for $15.00. To order, contact Scenarios USA, 110 West 18th Street, 6th Floor, New York, NY 10011 or phone 646.230.7677.


Transitions (ISSN 1097-1254) © 2002, is a quarterly publication of Advocates for Youth—Helping young people make safe and responsible decisions about sex. For permission to reprint, contact Transitions' editor at 202.419.3420.

Editor: Sue Alford

This publication is part of Transitions series. 

 
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AMPLIFYYOUR VOICE.ORG
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Apoyo para Jóvenes GLBTQ
for Spanish-speaking GLBTQ youth
MYSISTAHS.ORG
by and for young women of color
MORNINGAFTERINFO.ORG
information on emergency birth control for South Carolina residents
YOUTHRESOURCE.ORG
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